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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> , BuHding Department _
<br /> Date Recetved �'� - ��" - �p!� � Phone�Gontact for:Permitfle ��� �— CF �(� �
<br /> Owner's Name '-'l!l G�b e Owner Phone Nutnber -���} ��,�Cs �
<br /> Owner's Address 3 S � p ' Owrter Phone Number
<br /> � �
<br /> Fee Simple Tikleholder Name ` Owner Pfiane Number �+ �
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<br /> Fee Slmple Titleholder Address
<br /> JOB A13DRESS J�G7.S S�� ,[,_ i4l�V S 1�� (� LOT# I�z
<br /> SUBDlViS10N �� � PARCEI.tD# �2. "' �� � Z/ '
<br /> . (OBTAINED FRONI.PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADDlALT �,� SlGN Q. Q DEMOl.ISH
<br /> 'e INSTALI, 8 REPAIR , -
<br /> PROPOSED•�ItSE Q SPR [� CQMM Q QTHER
<br /> TYPE OF CONSTRUG710N xi [� BI.00K " Q FRAME � .[� STEEL Q �
<br /> DESCRIPTiZ1N OF WORK S ��C�"�� �Z3 d!�'� �-' �'L U"�� � 7s 2 �4 !�/�! � t.�o f� �
<br /> BU!!.DlNG SlZE " '`',{t X f,�j � SQ FQOi'AGE ` �U � : HEIGHT �L_.C2_�
<br /> QBtJIl.RII�lG $ '�a � .,x,_ ,. _; �-_ ._� � . -
<br /> p Af� VAIUATiON:.OP�70TAL CONStRt1GTION '�
<br /> QEl.ECTRICAI. �$ � AMP SEF2VICE Q PRiaGRESS ENEI2GY W.R.E.G.
<br /> �.,,,.,„_..„ Q
<br /> QPLUMBING 1�ff' � d
<br /> `r�C6(p C>
<br /> QMECHANICAL $ ' VALUATIQN OF'MECNAi+lICAI INSTRLLATIt?iV_ �' . ��
<br /> QGAS Q RQOFING Q SPECIAS.TY [� - QTHER�
<br /> FINISHED FLOOR ELEVATIONS r�� FLOOD ZONE AREA QYES NO
<br /> L .,
<br /> BUILDER x �} �..�.� ' `� COMPANY' 1,.,.4..�ti..0 Q �`��,��..�.�
<br /> SIGNATURE ��.�-a K. ��C' REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> , Addrass License# � � �
<br /> r
<br /> ECECi'RICIADl. r COMpA�IY • - v � �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ' ' �Y/N
<br /> Address _ . . license.# �~ �
<br /> P�.UMBER � , . � ,, �.CQMPAFlX . ' - -
<br /> SIGNATURE' " � _ _ REGI�7ERED . , Y/..N rl.,EEE CURRE� • " Y•/N � ' I
<br /> " •• -�,
<br /> Address - � _ , License#( �
<br /> MECHANlCAt:` GQMPANY, .,., �
<br /> St(3NATURE� � ' " ' � �' QEGIBTERED Y,J N FEE CURREt� Y:-/�N I
<br /> Addre�s' ` • ` . " ' '- • • ` License# ' . ` . „ � I
<br /> � OTi�FER " - `:COa1�9PANY. ;. �
<br /> SIGNATURE ` • '� � ' � ��� ' ' � -REGI3TERED Y/ N..- FEE CURRE� ' Y/N
<br /> Add[888 : + . . � ' LiC8itS9# �� �
<br /> .;;.. . r-. . .
<br /> RESIDEN'fiAl:,��, Attach'{2};P2otrP;4ahs„(2}sets:of:8ii1ld3'ng``Flaris;'{'I)'setof'Eriergy�Farrns;�12-0=W`Perznitfor'newccnstruc#an, :
<br /> � ; Minimumtiten�(;1.0);working�days_eiter,:"subrrilttat�date..�=Requlred onsite;ConstiucBon.Rlans,Stormwate'r'Pians w7 Silt Fence installed,
<br /> ' ""� SaniEary Facflides.;&c:1,;dumpste,r,.Slte War1c P.,ermitforsubdiytsions/Iarge;prnJecCs ,_ -
<br /> _ . C�M!!AEIBCDAl. -Attech{8)cainglete sef`sisf`Bul[dtitg Plans jilu`s a t.ife SaiBfy Page;{1}set of Ene►gy Fotm's.R-O W Peimit#o�nav+r consttuct�on. -
<br /> Minimum ten(10)waricing deys afker submittal date. Required onstte,CanstrucUan Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Fecilides 8�1 dumpster,Site Work Permit tor all new_projecfs:All commerclal requi[ements.must meet compliance � �
<br /> SIGN PERMIT Attadi{2)"sets of�EiiglrieeredcPlans.; ., =' � , , -
<br /> ••«"PROPERTY SURVEY required for all NEW construcUan. _ .
<br /> Directions: �� . � . :
<br /> Ffll out applicatlon completely.
<br /> Owner&Canfractor slgn back of appUcatlon,notadzed
<br /> If aver Sx5d4,a Natice of Commencemerit is tequired. (AtC upgrades over�'t500) -
<br /> �. �` .3=�;... U.. _.
<br /> Agent(for ttie�cantractor)or Powe�of Attamey:(for tFie owner)would;be someone with natarized letter tra:m�owner authiorizing'same.,� ,
<br /> DVERTHE COtlNTER PERMlTi1NG -- .•{Frontof- licattbn_Oni.,_-_:��'d.'. .� : ., .,,� `.�'"`';-`._.' ',{ ':
<br /> � �PP Y).` _ ' ' e • �;
<br /> ReroaFs if shingles Sewers Seroicu Upgrade"s �A/C ���•Fences,(PIoUSurvey/Footage) `! .. �,' "' �- '���- ' "
<br /> _ ... � � ,.._ : 1i,�...�i: _. _ ,. . �._ ..... ,.,, .,� �'4. r . :
<br /> Driveways-Not over Counter if an public'roatt6va'ys::n�eds ROW Y `;�t k� „ '��
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